Hi all-this is my first post here. I have a pretty complex situation, so I won't go into the details, but I've been struggling with Adderall tolerance for about 6 months. I'm up to about 120 mg per day (two 30mg XR plus 3 20mg IR) and it still sometimes isn't enough. I experience a lot of negative withdrawal symptoms if I try to take less or go too long without any. Sometimes that could be as short as 4 hours after a dose. I added Wellbutrin XL 150mg/day and it helped slightly. My psych is worried because my dose is so high and I'm only about 128 pounds, so she wants to add Strattera and try to take the Strattera up and the Adderall down--or at least stable.
I'm concerned about taking all three together - Adderall, Strattera, and Wellbutrin. I also take Xanax for occasional anxiety. Anybody with anything similar? I've tried Dexedrine Spansules and a thousand different dosing schedules with the Adderall, but I continually need increases. My body just builds up a tolerance too fast. (I'm 29, BTW.) Any suggestions?

No experienced advice here, but there is something called tachyphylaxis you might want to research. Google tachyphylaxis and stimulants for more info or ask your doctor. It's basically rapid tolerance. I read about it a few nights ago, but I can't remember much of what I read so I can't go into detail for you.

Hopefully someone taking higher doses/multiple meds will respond.

Hmmm... There are a couple of things you could do.

1) You mentioned 150mg of wellbutrin helped slightly -- how long were you on it? It takes up to 6 weeks sometimes to reach peak effect. Plus 150mg is the lowest therapeutic effect, so I would recommend increasing to 300mg, or even 450 mg over time, and that should do the trick. This will allow your brain to soak up even more dopamine and neuropinepherine and require a lower dose.

2) You could slowly taper off of your dose completely for about 2 months during the summer or sometime when you can take a long break from the meds. This should reset your tolerance. You can repeat this yearly to reset tolerance. Taking drug holidays weekly or monthly will also help so you never have to increase your dose once you find one that works.

4) Follow your doctors suggestions and take those three medications together. They all have similar actions, and strattera has caused TERRIBLE side effects for many so there is a concern there. But if this is the only option you have, go for it.

5) You gave all 4 of the options above a try, and nothing works:
YOU'RE SCREWED, so curl up in a corner.

Cheers.

I've been on loads of medications over the past few months. I know it's hard but I hope you stick with it to be able to find the combination of medications that will do the trick.

Strattera might do it for you as it is a non-stimulant. Wellbutrin XL is also not a stimulant. I've never heard of problems with taking those three together.

You should contact your medical professional for advice on taking your meds. No one on these forums is in a position to give you appropriate medical advice.

Yup.

There are "psych-drug" specialists called Psycho-Pharmacologists who *specialise* in complex situations of people who are taking Multiple Psychotropic Medications.

Talk to your Doctor and ask if this is appropriate.

NB #1 Some people on here have reported that Adderall and Wellbutrin (any 'stimulant' type drugs that stimulate the sympathetic nervous system) can make Anxiety worsen.

NB #2 Also, Xanax (a Valium relative) can make memory problems worsen. ADDers often have memory problems to start with... Xanax can also lead to 'rebound anxiety'. That means that the drug 'wears off' and THEN... the anxiety returns worse than ever. :(I also was on it; became very sick when stopping it; My Doc quit Rxing it to her patients in 1998.)

Xanax is considered (like Ativan too) to have high withdrawal/addiction potential b/c it 'wears on' and 'wear off' FAST.

just my opinion...

are u sure your not one of those people who think the initial (slight) euphoria (that fades naturally) is the actual effect of the drug? Some people increase their dosages chasing this euphoria. Also taking Welbutrin (has a stimulant effect) with stimulants increases your risk of seizures especially once the Welbutrin dose goes over 300mg. Decreasing Xanax dosages to quick will have the same effect. The other thing with Xanax is that after the quick 'wear off' you get hit with a rebound anxiety, the longer you have been taking it the worse this rebound can get. I ended up in a psychiatric ward from Xanax alone, and the withdrawal literally made me cross eyed for 5 days.

Im sure that was enough to get you on the edge of your seat, remember, its just my opinion from my experience.

My biggest word of advice is just to listen to the word of your doctor and dont take too much said in these seriously, some of the information is false, may not apply to you to at all and may make you feel worse like my post probably has.

For the sake of free speech i will say... Stimulant holidays do make a difference, but need to be done under supervision. Also i have found taking L-Tyrosine (the precursor to dopamine, the neurotransmitter being increased and possibly depleted by stimulants) lets me take less dextroamphetamine. Also magnesium is said to help with tolerance via its NMDA receptor activity, it also reduces side effects of stimulants and releives anxiety and depression (if your allready deficient). You need to be careful which type of magnesium you use also. Another option that ive seen mentioned a few times in forums is the use of dextromethorphan to reduce tolerance due to its strong NMDA receptor activity.

I also take a decent multivitamin and B vitamin complex because they have effects on your nerves also. I also just feel better for it to be honest, along with a bit of peice of mind that im helping my body out a bit.

These are just some ideas and/or things that have worked for me. Better if you talk to your doctor about them tho because i know taking tyrosine with welbutrin could be a problem, and having too much magnesium has issues of its own. Using dxm to reduce tolerance is best left to professionals also, maybe ask ur doctor to look into it.

I strongly advise against Straterra, when we tried him on it , he quit eating, he weent almost 2 weeks without anything to eat because Straterra made his stomach hurt so bad. Good Luck to you

from the Strattera page of Crazymeds website:
Interesting Stuff Your Doctor Probably Won't Tell You: You can't mix Strattera (atomoxetine HCl) and Wellbutrin (http://crazymeds.us/wellbutrin.html) (bupropion) because they don't play well together in your brain. They both want to grab the same precursors to activate the reuptake inhibition of norepinephrine, and as both work on norepinephrine mixing the two probably isn't such a hot idea in the first place. The details on this haven't been published anywhere that I've yet found, but there is a warning on Medline about mixing the two (http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a603013.html).
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: albuterol syrup or tablets (Proventil, Ventolin), amiodarone (Cordarone, Pacerone), bupropion (Wellbutrin), celecoxib (Celebrex), chlorpromazine (Thorazine), cimetidine (Tagamet), clomipramine (Anafranil), doxorubicin (Adriamycin), fluoxetine (Prozac, Sarafem), metaproterenol syrup or tablets (Metaprel), metoclopramide (Reglan), methadone (Dolophine), paroxetine (Paxil), quinidine (Cardioquin, Quinaglute, Quinidex), ranitidine (Zantac), ritonavir (Norvir), sertraline (Zoloft), and terbinafine (Lamisil). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
Most of the meds listed have to do with enzyme inhibition in your liver. That's just basic pharmacology. So any doctor prescribing the two together had better be doing so in very low dosages. Otherwise the doctor is really gambling with with your liver and your brain. What's left out of the above list is tonic water!
So if you want to control norepinephrine and dopamine reuptake individually, you have to go totally off label and use Mirapex (pramipexole dihydrochloride (http://www.crazymeds.us/mirapex.html)) or another anti-Parkinson's medication (http://crazymeds.us/alzandpark.html) for dopamine control.